From the Guidelines
The lab results show mostly normal values with a few abnormalities that do not require immediate intervention but should be discussed with your healthcare provider. The creatinine is slightly low at 0.68 mg/dL (reference range 0.70-1.20), which could reflect decreased muscle mass or good hydration status, and according to the ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008, a slight increase in creatinine is expected after initiation of certain medications, but a decrease is not typically a cause for concern 1. The CO2 is mildly elevated at 30 mEq/L (reference range 20-29), which might indicate a mild metabolic alkalosis, and the BUN/creatinine ratio is slightly high at 26 (reference range 7-25), suggesting mild dehydration or increased protein intake. Other values, including glucose, BUN, sodium, potassium, and chloride, are all within normal ranges. It is essential to stay well-hydrated and follow up with your doctor at your next appointment to review these results, especially if you're experiencing any symptoms or if these patterns persist on future lab work, and to monitor for potential adverse effects such as worsening renal function or hyperkalaemia, as outlined in the guidelines 1. Key points to discuss with your healthcare provider include:
- The low creatinine level and its potential causes
- The elevated CO2 level and possible underlying conditions
- The slightly elevated BUN/creatinine ratio and its implications
- Monitoring for potential adverse effects of medications, such as ACEIs, as recommended by the guidelines 1.
From the Research
Laboratory Results
- Glucose: 89 mg/dL (normal range: 65-99 mg/dL) [no relevant studies]
- BUN: 18 mg/dL (normal range: 7-30 mg/dL) [no relevant studies]
- Creatinine: 0.68 mg/dL (low, normal range: 0.70-1.20 mg/dL) 2, 3, 4
- Sodium: 143 mmol/L (normal range: 135-145 mmol/L) [no relevant studies]
- Potassium: 3.7 mEq/L (normal range: 3.5-5.2 mEq/L) [no relevant studies]
- Chloride: 104 mEq/L (normal range: 97-109 mEq/L) [no relevant studies]
- CO2: 30 mEq/L (high, normal range: 20-29 mEq/L) 5
- BUN/creat: 26 (high, normal range: 7-25) [no relevant studies]
Relevant Studies
- Metabolic alkalosis is characterized by elevated serum bicarbonate and arterial pH, and can be caused by various factors including vomiting, aldosterone or cortisol excess, and licorice ingestion 5
- Serum creatinine is a widely used measure of renal function, but has limitations and does not provide an accurate estimate of glomerular filtration rate (GFR) 2, 3, 4
- Renal function can be affected by various factors including hyperthyroidism, which can cause changes in electrolyte levels and renal function 6